A randomized study of training with large versus small vessel size on successful ultrasound-guided peripheral venous access.

Purpose: Our objective was to investigate whether training on phantoms with smaller or larger vessels would improve success rate in novice medical students learning this skill.

Methods: Medical students who participated in a voluntary, extracurricular ultrasound training day were asked to participate in the study as part of their procedural training. They were given a standardized education and demonstration of how to use ultrasound to place a peripheral intravenous (IV) catheter.

Use of ultrasound to diagnose and manage a five-liter empyema in a rural clinic in sierra leone.

We report the case of a dyspneic patient with a five-liter pleural empyema that was diagnosed and managed in a resource-limited clinic in a rural part of Sierra Leone. The diagnosis and management of this condition are usually guided by imaging modalities such as X-rays or CT scans. However, these resources may not be available in austere settings in developing countries.

A patient with a large pulmonary saddle embolus eluding both clinical gestalt and validated decision rules.

We report a patient with chest pain who was classified as having low risk for pulmonary embolism with clinical gestalt and accepted clinical decision rules. An inadvertently ordered D-dimer and abnormal result, however, led to the identification of a large saddle embolus. This case illustrates the fallibility of even well-validated decision aids and that an embolism missed by these tools is not necessarily low risk or indicative of a low clot burden.